If a couple has not been successful in getting pregnant after having normal fertility test results and there do not seem to be any identifiable fertility-related issues, this can be referred to as unexplained infertility. For many couples, it can be distressing as they undergo numerous rounds of unsuccessful medical intervention without being able to pinpoint the causes. Advancements in reproductive medicine have made it possible for physicians to use some new tools to identify and treat hidden causes of infertility previously. The ERA (Endometrial Receptivity Analysis) test is a useful tool for evaluating receptivity before transferring an embryo, thereby maximising the chance of successful implantation by identifying the optimal time for transfer.
The Endometrial Receptivity Analysis (ERA) is a molecular diagnostic test that assesses the endometrial receptivity, the uterus's ability to accept an embryo at any given time. Traditional methods for determining when an embryo should be placed in the uterus rely on the assumption of a general time frame for implantation. In contrast, the ERA identifies the time frame for implantation on an individual basis.
When a doctor performs an ERA test, the doctor obtains a sample of the endometrial tissue through a biopsy. The tissue is analysed to determine the expression of thousands of genes to assess whether the endometrium is receptive. After this analysis, the endometrium is classified as receptive, pre-receptive (too early), or post-receptive (too late). The analysis is used by doctors to optimise the timing of the embryo transfer.
In traditional IVF processes, embryo transfer is done on a standard time frame or cycle. However, not all women will have a typical time frame for embryo transfer. For example, the time may vary by a few hours or even days from one woman to another. Failure to recognise this difference can affect her chance for success. The ERA test allows for more accurate timing of embryo transfer based on the woman's unique implantation window, as indicated by the test results.
The use of the Endometrial Receptivity Analysis has opened opportunities for many women suffering from unexplained infertility.
Understanding the limitations of the ERA test helps create realistic expectations and allows informed decision-making.
Unexplained infertility is one of the most exhausting and difficult things experienced by couples trying to conceive. When standard tests fail to identify the cause, the ERA test can help reveal any underlying reasons. The ERA test provides the optimal timing for embryo transfer. The ERA test improves IVF outcomes by timing embryo transfer correctly. Though it does not yield successful results in all cases, it offers hope to many people trying to become parents.
Chief Infertility Specialist, MBBS(DU), FCPS(Obstetrics and Gynaecology), Fellowship in Assisted reproduction
Dr. Umme Ruman is a BMDC-registered infertility specialist based in Dhaka. She holds advanced qualifications in assisted reproductive techniques, sexual and reproductive medicine. Dr. Ruman serves as a Chief Consultant at Indira IVF Dhaka, helping patients with personalised fertility care based on her vast experience and expertise. Her knowledge and compassion will support couples navigating reproductive health challenges and guide them effectively towards their parenthood dreams.
IVF specialist, MBBS (SSMC), MS (Obstetrics and Gynaecology), Fellowship in Assisted reproduction
Dr. Rezwana Kabir is a BMDC-registered specialist in obstetrics and gynaecology, and now a part of Indira IVF’s team of fertility specialists in Bangladesh. She combines medical proficiency with a patient-centric approach, offering tailored solutions to couples seeking fertility assistance. She is committed to helping individuals confidently navigate the journey to parenthood through ethical, empathetic, and evidence-based care.
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